Women's empowerment and life stage: assessing intersectional differences in contraceptive method mix in sub-Saharan Africa

BackgroundWomens empowerment positively impacts family planning in sub-Saharan Africa, but little is known about its relationship with contraceptive method mix. Considering that contraceptive needs vary across life stages, we aimed to explore the intersectional differences in contraceptive method mix according to age and level of empowerment in sub-Saharan Africa. MethodsWe analyzed data from Demographic and Health Surveys conducted from 2015 to 2022 across 28 countries in West & Central and Eastern & Southern Africa. Within each region, we calculated pooled estimates of demand for family planning satisfied by any method (DFPS) and contraceptive method mix, stratifying by womens age and empowerment level according to the SWPER Global index. ResultsOur sample included 138,374 married women of reproductive age. Across both regions, DFPS increased with empowerment, especially among women older than 19. Among adolescents, a substantial increase was only identified in terms of decision-making. Contraceptive method mix was skewed towards injectables and implants, but their shares dropped as empowerment increased. This trend appeared across all age groups and empowerment domains, with the largest declines observed for social independence. High-empowered women had a more diversified method mix, with adolescents and young women showing increased use of condoms, pills, and fertility-awareness methods, while women over 34 relied more on IUDs and sterilization. ConclusionOur findings reveal that age, empowerment, and contraceptive method mix intersect in diverse ways. Tailoring family planning policies and counseling while addressing empowerment drivers could enhance informed contraceptive choices and better meet womens reproductive health goals.